1st
Response
Participant’s Resource
Resuscitation Council Guidelines 2015
Guidance for Participants
Changes to the 1st Response Participant’s Resource following
the Resuscitation Guidelines 2015 Guidance
As you may be aware, every five years the European Resuscitation Council
(ERC), the Resuscitation Council (UK) and the International Liaison
Committee on Resuscitation (ILCOR) review the latest research and
evidence in resuscitation, and then release updated guidelines. In addition
to this, for the first time in history, this year the European Resuscitation
Council (ERC) have also produced guidelines for first aid.
http://ercguidelines.elsevierresource.com/european-resuscitation-councilguidelines-resuscitation-2015-section-9-first-aid/fulltext
Resuscitation Council (UK) Guidelines
Whilst the guidelines have not
changed processes significantly, more
emphasis has been placed on:
the importance of early
intervention in an emergency
ensuring that first aid steps are
easy to remember, so that people
do something in a first aid
emergency.
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With these changes underpinning first
aid practice, Girlguiding and Scouting
has reviewed the 1st Response course
content and amended it to ensure
we are compliant. A summary of the
changes are below:
Principles of first aid
1.‘Shouting for help’ is no
longer a step to be taught on
its own.
The guidelines now instruct the first
aider to ‘ask someone to call 999’
after checking for normal breathing.
This further simplifies the guidelines,
making accurate recollection of the
sequence even easier.
2. Increased emphasis
on seizure as a possible
presentation of cardiac arrest
Immediately following cardiac
arrest, blood flow to the brain is
reduced to virtually zero. This may
cause a seizure-like episode that
can be confused with epilepsy. It is
also extremely important to teach
first aiders how to recognise agonal
gasps. Agonal breathing can sound
like gasping, snorting, gurgling,
moaning or laboured breathing. It is
NOT ‘normal’ breathing. In the event
agonal gasps occur start CPR.
3. Teach first aiders to
activate the speaker function
on their phone when calling
999 to help communication.
A common feature on modern mobile
phones, this addition helps the first
aider to communicate with the
Emergency Medical Despatcher at the
same time as assisting the casualty.
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4. ‘Unconscious’ to
‘unresponsive’
The term ‘unconscious’ has changed
to ‘unresponsive’, which is more
descriptive and easier to interpret
and understand.
5. Assessing the casualty
Previously people may remember
being taught a step-by-step approach
to assessing a casualty. Although
all these steps are still vital, the
guidelines stress the importance of
following the steps simultaneously
and quickly, with minimal
interruptions. When assessing a
casualty, the key steps to follow are:
ensuring the scene is safe
checking for a response from the
casualty
opening the airway and checking
for breathing.
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6. Role of the emergency
medical dispatcher
The new guidelines highlight the role
of the emergency medical dispatcher
(the person you speak to when you
dial 999) in supporting a first aider
in an emergency situation. It’s
important that the first aider stays
with a casualty when calling for
help and (if able) puts the phone
on speaker, to facilitate continual
communication with the emergency
medical dispatcher.
A casualty who is unresponsive
and not breathing stands a greater
chance of survival if a series of
events happen quickly, without
delay. This series of events is known
as the ‘chain of survival’, which is
made up of four elements:
early help such as calling 999
early cardiopulmonary
resuscitation (CPR)
early defibrillation using an
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Principles of first aid
7. The ‘chain of survival’
automated external defibrillator (AED)
early after care when the
emergency services take over.
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If any of the elements are missing
or delayed, the casualty’s chance
of survival reduces. The new
guidelines place more emphasis on
early intervention in an emergency,
and the importance of speed when
completing these vital steps.
European Resuscitation Council (ERC) First Aid
Guidelines
The key changes that affect how first aid is taught for Girlguiding and
Scouting.
8. Elevation and Indirect
pressure points are no
longer recommended for the
treatment of bleeding.
Elevation and indirect pressure
have been removed due to a lack of
evidence that either is effective in
stopping bleeding, particularly lifethreatening bleeding. For control of
bleeding apply direct pressure, with
or without a dressing, to control
external bleeding where possible.
Do not try to control major external
bleeding by the use of proximal
pressure points or elevation of
an extremity. However it may be
beneficial to apply localised cold
therapy, with or without pressure,
for minor or closed extremity
bleeding.
9. For the treatment of
Asthma, first aiders should
be taught how to administer
an inhaler and how to use a
spacer device.
The exact wording is “First aiders
must be trained in the various
methods of administering a
bronchodilator”. In the UK, that
includes assisting a casualty to take
their own prescribed inhaler and how
to take it using a spacer device. If
you think someone is having an
asthma attack, these are the five key
things to look for:
1 Difficulty breathing or speaking
2 Wheezing
3 Coughing
4 Distress
5 Grey-blue tinge to the lips,
earlobes and nailbeds (known as
cyanosis).
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Principles of first aid
Managing Asthma attacks
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First, reassure them and ask
them to breathe slowly and
deeply which will help them
control their breathing.
Then help them use their reliever
inhaler straight away. This should
relieve the attack.
Next, sit them down in a
comfortable position.
If it doesn’t get better within
a few minutes, it may be a severe
attack. Get them to take one or
two puffs of their inhaler every
two minutes, until they’ve had
10 puffs.
If the attack is severe and they
are getting worse or becoming
exhausted, or if this is their first
attack, then call 999/112 for an
ambulance.
Help them to keep using their
inhaler if they need to. Keep
checking their breathing, pulse
and level of response.
If they lose responsiveness at
any point, open their airway,
check their breathing and
prepare to treat someone who’s
become unresponsive.
For more information please see
https://www.asthma.org.uk/advice/
child/asthma-attacks/
https://www.asthma.org.uk/advice/
inhalers-medicines-treatments/
inhalers-and-spacers/reliever/
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10. Hypoglycaemia – first
aiders should aim to give 1520g of glucose.
Treat responsive patients with
symptomatic hypoglycaemia with
glucose tablets equating to glucose
15–20g. If glucose tablets are not
available, use other dietary forms of
sugar. For children use 10-15g sugar.
11. Oral Carbohydrateelectrolyte beverages (sports
energy-rehydration drinks)
now recommended for
exertion related dehydration.
Specific sports energy-rehydration
drinks have proven to be more
effective than water as they also
replace lost body salts. Use 3–8%
oral carbohydrate–electrolyte
(CE) beverages for rehydration of
individuals with simple exerciseinduced dehydration. Alternative
acceptable beverages for rehydration
include water, 12% CE solution,
coconut water, semi skimmed milk,
or tea with or without carbohydrate
electrolyte solution added.
12. Burns should be cooled
with water for a minimum
of 10 minutes, as soon as
possible.
Actively cool thermal burns as soon
as possible for a minimum of 10 min
duration using water. Subsequent to
cooling, burns should be dressed with
a loose sterile dressing.
The duration of delivering a breath
is about 1 second, to coincide
with adult practice. For chest
compressions, depress the lower
sternum by at least one-third the
anterior-posterior diameter of the
chest, or by 4 cm for the infant and 5
cm for the child.
14. Optimal position for a
shock victim
Place individuals with shock into
the supine (lying on back) position.
Where there is no evidence of
trauma use passive leg raising to
provide a further transient (<7 min)
improvement in vital signs; the
clinical significance of this transient
improvement is uncertain.
15. Stroke recognition
Use a stroke assessment system to
decrease the time to recognition and
definitive treatment for individuals
with suspected acute stroke. First
Aid providers must be trained in
the use of FAST (Face, Arm, Speech
Tool) or CPSS (Cincinnati Pre-hospital
Stroke Scale) to assist in the early
recognition of stroke.
Face ‒ look at their face and ask
them to smile. Are they only able
to smile on one side of their
mouth? If yes, this is not normal.
Arms ‒ ask them to raise both
arms. Are they only able to lift
one arm? If yes, this is not normal.
Speech ‒ ask them to speak. Are
they struggling to speak clearly?
If yes, this is not normal.
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Principles of first aid
13. Paediatric life support
Time ‒ if the answer to any of
these three questions is yes,
then it is time to call 999 or 112
for medical help and say you
think the casualty is having a
stroke.
16. Aspirin administration for
chest pain due to suspected
myocardial infarction
In the pre-hospital environment,
administer 150–300 mg chewable
aspirin early to adults with chest
pain due to suspected myocardial
infarction (ACS/AMI). There is a
relatively low risk of complications
particularly anaphylaxis and serious
bleeding. Do not administer aspirin
to adults with chest pain of unclear
aetiology.
17. Second dose of
adrenaline for anaphylaxis
Administer a second intramuscular
dose of adrenaline to individuals
in the pre-hospital environment
with anaphylaxis that has not been
relieved within 5 to 15 min by an
initial intramuscular auto-injector
dose of adrenaline.
There are three types of adrenaline
auto injectors available in the UK.
All deliver ‘adrenaline’ (also referred
to as ‘epinephrine’). All types are
prescription only medicines, and need
to be prescribed by a GP or Allergy
specialist. The dose of adrenaline
required is dependent on the age
and weight of the person requiring
the adrenaline auto injector device,
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Principles of first aid
and will be prescribed by the doctor.
Each adrenaline auto injector device
will differ in appearance and the
availability of the dose/strength
available in that particular brand.
The way each device is used
is different, so it is important
that you are shown how to
use the device.
For more information please see:
https://www.allergyuk.org/severeallergy-and-anaphylaxis/adrenalineauto-injectors
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18. Eye injury from chemical
exposure
For an eye injury due to exposure
to a chemical substance, take
immediate action by irrigating
the eye using continuous, large
volumes of clean water. Refer the
individual for emergency healthcare
professional review.
19. Recognition of concussion
An individual with a suspected
concussion should be evaluated by a
healthcare professional.
20. Dental avulsion
If a tooth cannot be immediately
re-implanted, store it in Hank’s
Balanced Salt Solution. If this is not
available use propolis, egg white,
coconut water, ricetral, whole milk,
saline or Phosphate Buffered Saline
(in order of preference) and refer
the individual to a dentist as soon as
possible.
Using a defibrillator (AED)
An AED (automated external
defibrillator) is a device that gives
the heart an electric shock when
someone’s heart has stopped (cardiac
arrest). You can use an AED on
children over one year old and adults.
Ambulances have them on board, but
using an AED in the minutes before
an ambulance arrives can double
someone’s chances of survival. So it
is up to bystanders quickly to find the
nearest defibrillator.
Where can I find a defibrillator
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Many public places keep an AED as
part of their first aid equipment,
including shopping centres, train
stations, airports, offices and schools.
AEDs come in a small portable plastic
box and are stored in noticeable
green casing with a green sign above.
If you don’t have access to an AED
then you should call 999 or 112 for
help and do ordinary resuscitation
(CPR) until the ambulance and AED
arrives.
How do I use a defibrillator/AED?
You can use an AED with no training.
The machine analyses someone’s
heart rhythm and then uses visual or
voice prompts to guide you through
each step.
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Principles of first aid
Additional information
1 First, make sure someone
has called for an ambulance,
and, if an AED isn’t
immediately available,
give CPR (cardiopulmonary
resuscitation) until someone can
bring you an AED.
2 As soon as you’ve got an AED,
switch it on. It will immediately
start to give you a series of visual
and verbal prompts informing
you of what you need to do.
Follow these prompts until the
ambulance arrives or someone
with more experience than you
takes over.
3 Take the pads out of the sealed
pack. Remove or cut through any
clothing and wipe away any sweat
from the chest
4 Remove the backing paper and
attach the pads to their chest
5 Place the first pad on their
upper right side, just below their
collarbone as shown on the pad
6 Then place the second pad on
their left side, just below the
armpit. Make sure you position
the pad lengthways, with the long
side in line with the length of the
their body
7 Once you’ve done this, the AED
will start checking the heart
rhythm. Make sure that no-one
is touching the person. Continue
to follow the voice and/or visual
prompts that the machine gives
you until help arrives.
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Principles of first aid
Additional resources
Health Matters Product Code: 6454
This useful resource gives practical,
common-sense advice on preparing
for health-related problems that
can arise and managing common
illnesses and conditions. Written by
Leaders with many years’ experience
of providing first aid in guiding, it
will help you to deal confidently with
health issues at unit meeting, on days
out during camps, holidays and trips.
Topics covered include:
Roles and responsibilities of first
aiders and Leaders
Planning - Getting medical help
Travelling abroad
Minor ailments
Existing health conditions
First aid kits.
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